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White Spots After Braces

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My daughter had braces for almost three years. When they were removed, we noticed white spots on her teeth. We spoke to our dentist about it and he suggested we just have her teeth whitened to even it out. The problem is, it didn’t even them out. Her teeth are whiter, but so are the spots. What do we do now?

Lacey

Dear Lacey,

A professionally-made take-home custom tray for teeth whitening.

While I am certain your dentist meant well, he does not really understand how teeth whitening works. As you have discovered, teeth whitening will whiten the tooth structure evenly. It is not designed to even out color.

Let’s start with what those white spots are and then I will give you the next step to take. When you have white spots after braces, those are decalcification spots— pre-cursors to decay. This is fairly common after braces, especially in children and teenagers because those metal wires and brackets are difficult to get around when you are brushing your teeth. That is just one of the reasons I often recommend Invisalign to my patients instead of braces. These do not have any metal wires and brackets. Plus, they are removable, which makes oral hygiene a breeze.

The correct way to deal with these is to have a cosmetic dentist gently remove the white spots with some microabrasion. Then, he or she will recover the area with a composite dental bonding. I am going to suggest you don’t go to your regular dentist for this. It is a rather advanced cosmetic procedure, way more advanced than teeth whitening. Plus, it has to be done freehand. You really need someone who has expertise to do this. One thing to do is check out their smile gallery. Look specifically at their dental bonding cases. If you like the results you see, that will be a safe dentist for you to see. One word of caution. Double check that the images are cases the dentist has done and not just stock photos.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Does Smile Direct Club Work?

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I keep seeing advertisements all over my facebook page for Smile Direct Club. I have always wanted to straighten my teeth but haven’t had quite enough money to jump on the Invisalign train. I looked into the smile direct cost and it is enough cheaper that I could do it. I do worry about safety with these do it by mail medical things though. Have you by any chance looked into Smile Direct or had patients that used them? If so, what impression did you get?

Lacey

Dear Lacey,

Smile Direct Club Ad

I am glad you wrote. I’ve actually looked into Smile Direct Club quite extensively. I want to be up to date on as much as possible. This treatment has worked for some people. For others, it has been a disaster. Let me go over the things that concern me about their process and then you can make a decision from there.

No Pre-Exam

The first thing that worries me is that they are beginning orthodontic treatment without a complete exam. In order to safely begin orthodontics you need x-rays, a full dental exam, as well as careful checking for periodontal disease. Without that, you risk serious complications. If you have periodontal disease and start moving your teeth around they can begin to come loose. This is a basic safety measure.

DIY Impressions

Another issue is the impressions. When a dentist does these for a company, such as Invisalign, they have to be perfect. That means no bubbles, no tears, or any other type of defect. This is such an important part of treatment that most dentists do not even let their dental assistants do it. With Smile Direct, you’re just given a home DIY kit and they make the best out of whatever you send them.

Inadequate Monitoring

With Invisalign or another invisible braces brand, your dentist follows up with you every two weeks. This is important because the human bodies are as unique and varied as personalities. Things do not always go exactly as planned and adjustments have to be made to keep the treatment on track. You will not get that with Smile Direct, nor does the average customer of theirs even have the training to recognize if something is not following the prescribed protocol.

Crowding

Most cases that need orthodontics are because of overcrowding in their bite. When that is the case, the patient will sometimes need an extraction in order to make space for your teeth to be in proper alignment. In some cases where not much space is needed, a dentist can carefully shave away some tooth structure to make the necessary room. With Smile Direct, there is no personal care and this process is short cut out.

If You Don’t Have Money for Invisalign

My suggestion is to wait and save to have this done right. You can also call around and see what brand of invisible braces other dentists use. Invisalign is not the only brand and some of them cost less and give great results all under the care of a dentist.

By the way, if you want to, your dentist can provide you with teeth whitening gel. The Invisalign aligners can double as bleaching trays allowing you to straighten and whiten your teeth at the same time.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Porcelain Veneers or Invisalign?

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I have been saving up for quite some time to get my smile makeover done. There’s nothing too major. I want the color whiter, there are some chips here and there, and I have one slightly crooked front tooth. It’s not crooked enough where I ever considered braces. However, my dentist is suggesting I have Invisalign done before getting the porcelain veneers. He said that way there wouldn’t be any need for tooth preparation because he’s using Lumineers. I am not too keen on the idea of adding another 9 months to my smile makeover. Is this completely necessary? I thought porcelain veneers could make a tooth look straight. Am I misunderstanding anything?

Patricia

Dear Patricia,

invisible braces

Bear in mind that I haven’t examined you, but I am skeptical of what your dentist is telling you. In almost all cases, you would either do porcelain veneers or Invisalign–not both. You had the right idea that porcelain veneers can make your teeth look straight. My guess is your dentist is trying to get you to do the Invisalign because he doesn’t know how to shape teeth with porcelain veneers.

He also suggested Lumineers for your case, which is a brand of porcelain veneers highly marketed to inexperienced cosmetic dentists as being “easy to place” because they don’t require tooth preparation. However, in most cases, Lumineers end up looking bulky without some tooth prep. Not to mention inexperienced cosmetic dentists do not generally know how to produce beautiful results. Smile makeovers aren’t taught in dental school.

At this point, you have two choices if you want to get porcelain veneers, I would get them but with a different dentist. Look at their smile galleries to make sure you like the type of results they get. You want to know that they can produce beautiful, natural-looking smiles. Also, make sure they have some type of beautiful smile guarantee.

A second option is to do get Invisalign or another brand of invisible braces to straighten your teeth and whiten your teeth simultaneously using the clear aligners as teeth whitening trays. This will be significantly less expensive than porcelain veneers, but will take longer. You mentioned a few chips on your teeth. You didn’t mention how many or how large, but in most cases, these are repaired with some dental bonding.

Truthfully, wanting all three things repaired, which is what would be necessary for a complete result, the porcelain veneers will be a better idea. I just don’t think your current dentist is the one to do it. He sounds to be in over his head but not wanting to admit it.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.

Porcelain Veneers and Invisalign?

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I want to upgrade my smile. I need them whiter and my two front teeth are a tad crooked. I was thinking of getting porcelain veneers. My dentist suggested I get Lumineers, but before that he wants me to get Invisalign to straighten those two teeth. I just want to get a sort of “second opinion” before going through all that.

Amara

Dear Amara,

invisible braces

Bear in mind when I give you an answer that I haven’t seen your case, so I’m giving generalities here based on what you’ve written. In general, you would either do Invisalign or porcelain veneers, not both. Porcelain veneers can make your teeth look straight. You mentioned it is only your two front teeth which are crooked, which shouldn’t be too complicated. It’s possible your dentist is just in over his head and he doesn’t know how to fashion porcelain veneers except under the ideal conditions.

Rather than say that, he is suggesting you use Invisalign to fix the crooked teeth and then he’ll place Lumineers. That brings me to another reason I think he is in over his head. Lumineers is a particular brand of porcelain veneers that is heavily marketed to inexperienced dentists as being easy to place. Your case is a smidge more complicated.

You haven’t mentioned anything about needing or wanting to change the size and shape of your teeth. Aside from the front teeth, you’ve only mentioned wanting to whiten their color. If that’s the case, porcelain veneers may not be necessary.

You can whiten and straighten your teeth all at once using invisible braces, saving you thousands of dollars. My suggestion is you get Invisalign to straighten your teeth. The aligners can also double as teeth whitening trays. Your dentist simply has to provide you with the whitening gel. Wear the gel while you’re straightening your teeth. When you are done, you’ll have beautifully straight, white teeth.

Additionally, these two procedures are simple enough they can be done even by inexperienced cosmetic dentists. If you were to get porcelain veneers, I would recommend you go to someone with more expertise.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Will Invisalign Fix Misalignment?

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I went to see my dentist about Invisalign and he said that he looked into it years ago and it was only for certain basic orthodontic cases and didn’t feel it was worth it. Will Invisalign fix misalignment or do I have to go the whole traditional braces route? I’m about to start my first “professional” job and was really hoping not to look like I am still in Junior High School. As it is I look very young and I want to be taken seriously.

Meghan

Dear Meghan,

invisible braces

Congratulations on the beginning of your career journey! What an exciting time in your life. I completely understand you wanting to be taken seriously by all the old fogey’s who’ve been at their desk for so many years they’re almost melded into the furniture. Invisalign is the perfect way to do that.

Based on your dentist’s comment, I’m guessing he hasn’t looked at Invisalign since it first came out. Some dentists are better than others at keeping up with the technology in their field than others. While it is true that when this procedure was in its infancy, it only worked for the basic cases of misalignment. These days, it is a completely different story. It can handle all but the most complicated. So, this would be a perfect procedure for a young professional like yourself.

I would get a second opinion from a dentist with a lot of experience treating with invisible types of braces, such as Invisalign. They’ll be able to tell you if it will work for you. I have a feeling, unless you’ve got something rather strange going on that it will work just fine.

Mini Smile Makeovers with Invisalign

One hidden benefit of the aligners used to straighten your teeth is they can double as teeth whitening trays. This means you can straighten and whiten your teeth simultaneously without anyone even knowing. As it sounds like you are just out of college, you may not need the whitening yet. However, I recommend you save your last pair of aligners to use later down the line when you do feel like some brightening of your teeth will work.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Is it Safe to Use Brands Other Than Invisalign?

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I went to see a dentist about getting Invisalign. He says I am a good candidate but doesn’t use the Invisalign brand. He prefers another one which he says gives him better treatment options. My question is, do other brands work as well or should I find a dentist who is trained in Invisalign?

Macy

Dear Macy,

invisible braces

While Invisalign was the first brand of invisible braces and it has the most name recognition, there are other brands that work very well. Dr. Marion prefers one of those other brands for his patients as well, though he doesn’t have anything against Invisalign.

He prefers the other brand for two reasons. First, the cost is less. That savings is passed onto his patients. Another reason is control. He gets more options to change treatment. This also benefits his patients. While many times treatment goes just the way it should be, our bodies are all unique and respond differently to the same treatments. When things aren’t going according to plan, the dentist needs the freedom to make the changes necessary to get things on track.

A Second Cosmetic Benefit of Invisible Braces

Everyone knows invisible braces will straighten your teeth. However, there is a second benefit that many patients never learn about. The clear aligners are so well-fitted to your teeth that they can double as teeth whitening trays. This will allow you to straighten and whiten your teeth simultaneously. This is like getting a mini smile makeover.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.